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Clinical Services and Measures of Quality

You have recently been hired to improve the quality of services at a healthcare organization. Your supervisor would like to hear about your plans for improvement. In particular she wants you to send her an email answering the following question:

What are the advantages and disadvantages of “process” and “outcome” measures of quality? Please cite all references

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Class Text book “The Well Managed Healthcare Organization” By John R. Griffith & Kenneth R. White 2002.
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I have attached my response (also below) to your question: “What are the advantages and disadvantages of “process” and “outcome” measures of quality?” I have included all references. I also attached an easy to follow article as one example of an outcome measure, that of disease frequency: rates, ratios, frequencies and their calculation. This article also nicely charts the measurement and research methods employed by healthcare organizations to ensure high quality programs. Since you are going to be responsible for all the services provided by the organization, you will have to consider what type of questions need to be addressed and the type of data that needs to be collected to provide the most effective programs. After considering the advantages and disadvantages of the two types of measures, you would then decide which one (or both) fits with the research and evaluative purposes.

I hope this helps. Good luck with your studies and take care.

RESPONSE:

Your question was this: “What are the advantages and disadvantages of “process” and “outcome” measures of quality? Please cite all references.”

Unfortunately, I do not have access to your text by Griffith & White (2002). However, your question is a very general question about program evaluation, which is addressed by many authors and researchers. Indeed, researchers, health care practitioners, policy makers, administrators, and consumers have identified the need for evaluation of health care treatment programs in order to ensure their efficacy and cost effectiveness. A useful starting point in guiding these decisions is to consider broadly the different types of evaluations and consider the advantages and disadvantages of each.
Champagne et al. (1986) (Source: Champagne, F., Contandriopoulos, A. and Pineault, R. (1986). A Health Care Evaluation Framework. Health Management Forum) distinguish between three types of service and administrative evaluations: structure, process and outcome (see Figure 1).

  1. Structure Measures

Structure evaluations consider “the quantity, quality and organizational characteristics of a program: the focus being on human, physical, and financial resources”. Structure measures relate to the organization of a program, the number, training and competency of staff, the comprehensiveness of services, and the accessibility of services. Structure measures are proxy measures for process and outcome; the assumption being that the better the structure, the better the process and outcomes. Structure measures only indirectly address the outcomes of a program, and, although this may be the easiest and least expensive type of evaluation, it is also the weakest in terms of final outcome assessment.

  1. Process Measures

Process evaluations relate to the actual services that are rendered. They address issues related to what staff and professionals do, how they do it and the …

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